Is It Safe To Co-Sleep With My Baby?

Posted by Robyn Hunt & Julie Monson on Jul 15, 2021

Co-sleeping with your baby is a lovely way to bond and also a convenient way to feed your baby at night without having to get out of bed. This age old practice of being close to you for warmth and comfort is arguably a natural way for babies to sleep. However, co-sleeping and bed-sharing is a contentious topic, and one that we know sparks a lot of debate.

The majority of reputable medical organisations agree that babies should room-share with their parents for the first 6 to 12 months as it has been found to reduce the risk of SIDS. They also agree that babies are safest sleeping on their backs, in a clear sleep space free of pillows, blankets and other potential suffocation hazards. But there is much discrepancy about whether parents should be advised against sharing their beds or the same sleep surface with their baby as well.

In this article we will take a look at the current research and evidence available, and empower you with knowledge on the risks of bed-sharing, and how to co-sleep as safely as possible with your baby if you choose to do so.

Is there a difference between co-sleeping and bed-sharing?

Co-sleeping is a term broadly used to describe a baby or child sleeping in the same sleep area as their parent/s. There are generally two types of co-sleeping;

The first is called “room-sharing” which is a term used to describe a baby sleeping in their own cot or sleep space but in their parents’ room or sleep area.

The second type of co-sleeping is called “bed-sharing” which is the term used to describe when a baby or toddler sleeps in the same bed or on the same sleep surface as their parent/s. This is where the differences in opinions comes in.

IS ROOM-SHARING SAFE?

The American Association of Paediatrics (AAP) developed the Safe Sleep ABC. They encourage sharing a room with your baby especially for the first 6 months, however, they discourage sharing a bed. Sharing your room with your baby allows you to respond quickly to your baby if they become distressed.

A large study of evidence from across Europe found that the risk of sudden infant death was significantly reduced when babies slept in the same room, but not the same bed, as their parent/s.

Placing your baby to sleep on a separate surface such as a co-sleeper or Moses basket next to your bed is the safest place for them.

Is bed-sharing safe?

This answer is not completely clearcut as it depends heavily on the specific situation. Studies have found that bed-sharing is the most common cause of sleep-related death in babies, with the highest rate in babies who are 4 months and younger.

Bed-sharing may disturb parents’ sleep less, as your baby is close to you which gives them a sense of security and reduces the amount of times they wake up during the night. However, an adult bed is not considered a safe sleep space for a baby due to various potential dangers.

In most cases, bed-sharing comes with an increased risk of suffocation, entrapment, overheating, injury, and an overall higher risk of SIDS (Sudden Infant Death Syndrome) for the baby.

What makes bed-sharing so dangerous?

Doctors from around the world have issued warnings against bed-sharing with babies. These recommendations are based on Western studies which have shown a substantial link between bed-sharing and SIDS (Sudden Infant Death Syndrome).

In addition, babies who sleep in traditional, Western-style adult beds have been shown to have a much higher chance of accidental suffocation, entrapment, entanglement, falling and overheating.

Western-style beds were designed for an adult. They were designed for the sole purpose of comfort while sleeping and usually have heavy blankets, duvets, quilts, comforters, pillows, loose sheets, and a softer mattress. When a baby sleeps in this type of bed with one or both parents, the risk is higher. The bedding could cover your baby’s mouth and/or nose leading to suffocation, or it wrap around their neck leading to strangulation.

The same applies to adult mattresses, as they can be too soft for your baby which may cause them to sink into the mattress and increase the risk of accidental suffocation.

There is also the risk of a parent accidentally smothering the baby, especially if the parent has consumed alcohol or sedating medication or drugs.

There have also been many reports of babies falling off of the bed during the night causing moderate to severe head injuries.

pillows, blankets, cot bumpers not safe for babies

Is it safer to use a pod or sleep nest in my bed?

Sleeping pods and nests are often advertised as “safe” sleeping spaces for babies, however, they do not meet the required standards of a firm, flat surface and are not considered safe for a baby to sleep in.

It is not recommended that babies sleep on soft surfaces such as pods or nests. If you choose to co-sleep with your baby the safest place is a clear space on a firm flat mattress.

Are independent co-sleeper cots safe?

There are some co-sleeper cots that can be used next to your bed. Approved co-sleepers should have EN 716 approval. Many of these co-sleepers can be attached to your bed with straps.

When using co-sleepers, there is still the risk of your blankets or pillows accidentally covering baby’s face and there is also a risk of the baby getting trapped in between the co-sleeper and your bed.

Obviously, the manufacturers of the co-sleepers have tried to prevent this by making co-sleepers attach securely to the bed, however, there will always be a slight gap and no matter how small, it is possible for a baby to get trapped or fall through the gap. It is therefore recommended that you pull the cot sides up to prevent this from happening.

Furthermore, once a baby can roll over, it is recommended to stop using co-sleepers because of the risk of baby rolling into the parent’s bed during the night and the parent rolling on top of the baby.

IF WE REMOVE SOME OR ALL OF THE POTENTIAL DANGERS, IS BED-SHARING THEN SAFE?

This is where many experts in the field disagree. After many years of extensive research, the American Association of Paediatrics have concluded that babies should room-share without bed-sharing, for the first 6 to 12 months. They recommend that babies should sleep in their parents’ room, close to the parents’ bed but in their own cot/ campcot/ co-sleeper /bassinet. They believe that it is unsafe to bedshare no matter the circumstances.

However, the International La Leche League, who are experts in lactation, suggest that if bed-sharing is done safely, then it should not pose a significant risk to the baby.

They indicate that bed-sharing may help with breastfeeding as well as sleep quality and quantity for both baby and parent. They developed the “Safe Seven” in order to promote safe bedsharing. However, we can find no evidence to support that Safe Seven is proven to be safe.

Read our blog "Is It Safe To Sleep While Breastfeeding?"

The Lullaby Trust and UNICEF agree that it is safest for babies to sleep in their own cots without any bedding. They acknowledge that many families still opt to bedshare as it is often the easiest way to get your baby to sleep and to feed at night. They recommend that if parents do choose to bedshare, that your bed be made a safe space for your baby by:

Keeping pillows, sheets, blankets away from your baby or any other items that could obstruct your baby’s breathing or cause them to overheat. A high proportion of infants who die as a result of SIDS are found with their head covered by loose bedding.
Follow all of their other safer sleep advice to reduce the risk of SIDS such as sleeping baby on their back.
Avoid letting pets or other children in the bed.
Make sure baby won’t fall out of bed or get trapped between the mattress and the wall

They believe if the above is adhered to and you have sober habits, and your baby was not premature or born with a low birth weight, then the risk of SIDS is lower, and bed-sharing can be done reasonably safely.

What age is bedsharing considered less risky?

Most SIDS deaths related to bed sharing occur before one year of age. Bedsharing with a baby younger than four months old comes with the most risk, and as they get older, the risk decreases slightly.

Therefore, its recommended to hold off until your little one is around one year of age before letting them sleep in your bed with you but if you need to bed-share sooner, try to wait until your baby is at least 4 months old and past the riskiest period.

Is it safer to just hold my baby in my arms or on my chest while bed-sharing?

Holding your baby in your arms or on your chest while you are sleeping is potentially more dangerous than your baby sleeping directly on your bed (on his/her back). As a new parent you are usually overtired and have been getting very little sleep since your baby was born.

When a person is overtired, they are more likely to go into a very deep sleep where usual noises and movements will not wake them up. This means that parents are more likely to drop their baby in the bedding or off the bed, roll over onto their baby or turn over in their sleep which could cause the baby to fall off the bed or position them in a hazardous environment (with blankets over their faces, for example).

If you are holding your baby and start to feel sleepy, rather put your baby into their own safe sleep space or ask your partner or family member to take the baby for an hour or two so you can catch up on some sleep, safely.

What risk factors increase the dangers of bedsharing?

The risk of accidental suffocation, entrapment, strangulation, injury, or death while bedsharing increases substantially if the parent:

Smokes cigarettes frequently
Consumes alcohol frequently or before going to sleep
Takes recreational drugs.
Takes prescribed medicine to help them sleep
Feels unusually tired.
Feels unwell or is sick·
Takes medication that impairs alertness and judgement.
Suffers from post-partum depression

The risk of Sudden Infant death Syndrome while bedsharing increases substantially if the baby:

Was born prematurely.
Was a low weight at birth.
Can roll from back to stomach and stomach to back.
Has been overdressed
Is formula fed
Underwent surgery shortly after birth

in conclusion

While bed-sharing may have certain benefits such as encouraging breastfeeding and convenience during night feeds, there are no scientific studies demonstrating that bed sharing reduces SIDS. Conversely, there are studies suggesting that bed sharing, under certain conditions, may actually increase the risk of SIDS.

The safest proven way for your baby to sleep is on his/her back, in his/her own cot in your bedroom, for the first 6-12 months. This allows you to monitor your baby and attend to their needs quickly.

We know that many babies simply do not settle when placed on their own in a cot, and that bed-sharing may be the most practical way for you and your baby to sleep. If you do choose to co-sleep, the following is recommended in order to bedshare as safely as possible:

Try to avoid bedsharing with a baby that is under 4 months of age.
Remove ALL loose bedding including duvets, blankets, pillows, comforters, extra sheeting, etc.
It is safer for baby to sleep in a bed with one parent instead of both parents (and other children or pets).
Move the bed away from walls and other objects that baby can get trapped in between.
Place the baby in the middle of the bed away from the edges.
Place the baby on their back to sleep every time.
Adhere to safe sleep guidelines regarding sleep sacks, swaddles, how to dress baby for the current climate, etc.
Move the bed away from curtains and blinds.
Only bed-share on a bed. Do not co-sleep on sofas, couches, recliners, or rocking chairs.
Avoid holding your baby or placing baby on your chest to sleep.